Narcotics Maximus

[Boatswain2PA]

10 hours ago, EMEDPA said:

an elective procedure that would be free in most of the developed world

Wrong....it wouldn't be free.  Someone would pay for it....just not you (although, taking it a step further, you would pay even MORE taxes in order to pay for your elective procedure....along with many other people's).

[EMEDPA]

of course someone would pay for it, but it would be covered. the risk would be spread across the entire population.  I would be ok with higher taxes if it meant the kind of benefits folks get in France(paid time off after having kids, 100% medical coverage, 35 hour work week, etc). since I am already paying 50% taxes AND almost 2k/month for medical only(no dental or vision), I'm guessing I would come out ahead financially in France or Germany (or Spain, or Finland, or Denmark, etc). 

[ventana]

So from my memory

 

We already have the state/govt funding something like 65-70% of all care (add up SSI, VA, Medicare, Mediaid)

 

We just have such a fragmented system we suck

 

We already are spending the money on it - only category we lead in WHO rankings is per capita spending!  We just need to get our monies worth!!

 

Really would not take increasing taxes, but instead just managing what we already spend...

[Boatswain2PA]

Better to decentralize it.  Only people who should have federally funded healthcare are federal employees/military.  Leave everything else up to the states.  

[weezianna]

Just responding to the original premise of this thread - and appreciate all the replies to my situation as well as the healthcare discussion.

I specifically asked the Chief of Pharmacy what their policies were, and she basically said there wasn't one and that she wasn't my supervisor.  She cc'd the Medical Director who again said that writing for narcotics in these circumstances was merely like covering a vacation. 

I have replied that I will forward questionable requests from the other clinic back to the provider.  I haven't gotten any more thus far, so they either have the NP filling them or don't want to have to deal with me.  My days are numbered here anyway as a locums, and I probably have been labeled as a pain in the you-know-what.

[Reality Check 2]

Your VA location sounds woefully underinformed - there are HUGE national VA policies on narcotics.

Your Medical Director sounds complicit with bad behavior.

Were you able to locate the actual CHIEF OF STAFF?

You can print out the VA directives and conveniently and anonymously leave them on desks.

I feel certain the director of the VISN would be fascinated to hear all this.

Sad to hear that not all VAs are created equal.

Hope your time is short and you can get out unscathed.

[thinkertdm]

17 hours ago, weezianna said:

Just responding to the original premise of this thread - and appreciate all the replies to my situation as well as the healthcare discussion.

I specifically asked the Chief of Pharmacy what their policies were, and she basically said there wasn't one and that she wasn't my supervisor.  She cc'd the Medical Director who again said that writing for narcotics in these circumstances was merely like covering a vacation. 

I have replied that I will forward questionable requests from the other clinic back to the provider.  I haven't gotten any more thus far, so they either have the NP filling them or don't want to have to deal with me.  My days are numbered here anyway as a locums, and I probably have been labeled as a pain in the you-know-what.

It seems you are not covering for a provider who is on vacation, but one is unable to write for narcotics for whatever reason.

As you are not the pcp of record, it would seem that if/when an adverse event happens, you are on the hook.  Some states have pretty strict rules about narc refills without a physical exam, etc.  And your narc prescriptions do get reported to the state in a federal facility.  I've even known of PA's getting selected for state audited cme while in a VA.

[weezianna]

Reality Check 2 and thinkertdm - I realize that there are narcotics directives at the VA - I worked at the VA full time for almost 6 years  The system that I am currently working in is vastly different than the others when it comes to this policy.  I am not "covering" for a provider on vacation, but the Chief has equated writing these rx's to this situation.  I certainly realize that federal prescriptions get reported to the states, and query the websites with every rx I have written.  It seems, though, that they are having someone else write for this provider., and I am no longer receiving these requests.  I believe that they are trying to do everything to keep this provider on board, as they have had difficulty recruiting an MD to this remote site.  Regardless, I am out of here shortly.